Search Results for: stop-loss

American Rescue Plan Act Will Strengthen Public and Private Health Insurance

By Edwin Park* and Sabrina Corlette The House and Senate have passed the American Rescue Plan and the President plans to sign it today, bringing critical relief to America’s families. In addition to providing relief to unemployed workers, pulling millions of children and families out of poverty and helping school districts address learning loss, the COVID-19 relief legislation will strengthen…

Removing Roadblocks: Special Enrollment Period Data Show Increase in Marketplace Signups

When the COVID-19 pandemic struck last year, the Affordable Care Act (ACA) acted as a critical safety net. As millions faced job and income loss in the face of a growing threat of infection and disease, Medicaid, expanded under the ACA in most states, and the law’s health insurance marketplaces provided coverage and financial assistance. Notably, states sprang into action…

Are the Good Times Over for Health Insurers?

…did in 2019, several major health insurers reported reduced profits or even losses in the fourth quarter of 2020. Humana posted a $274 million loss, a record for the insurer. Centene reported a $12 million loss in its fourth quarter and subsequently announced it will cut 3,000 employees from its staff. Other insurers including Aetna and UnitedHealth had a decrease…

An Opportunity to Protect Consumers and Ensure a Level Playing Field: Reversing Trump-era Rules on Association Health Plans

…Further, the Court concluded that Congress did not intend for self-employed individuals with no employees to be considered “employers” under ERISA. The Trump administration appealed that ruling, and the case has been pending for over a year. The Biden Administration can Foster Stability for the Small-group Market To protect consumers, small businesses, and providers (who often face significant financial losses…

January Research Roundup: What We’re Reading

…recent job loss or receipt of unemployment benefits, receipt of failure to file notices due to IRS backlogs in processing income tax returns, and policies discouraging enrollment among eligible immigrants. Due to both general and pandemic-related difficulties experienced by many consumers during the 2021 Open Enrollment period, Navigators advocated for reopening the federal marketplace for an additional enrollment period. Navigators…

Health Insurance Companies Spent Millions to Defeat the Affordable Care Act. Now They’re Embracing Policies to Expand It.

…to fully subsidize COBRA premiums for Americans who lost their employer sponsored insurance. As talks for another COVID-19 relief package ramped up last fall, AHIP again highlighted the need for temporary COBRA funding as job losses and furloughs continued. KFF estimates that COBRA subsidies could cost the government $106 billion, while many of those opting for COBRA would be passing…

Expanded Coverage For COVID-19 Testing Must Include Limits On Costs

…patients in a limited Medicaid benefit to pay for testing with a 100% federal match, but the process can be cumbersome and to date only 17 states have adopted it, according to Kaiser Family Foundation. In the remaining states, and as a backstop for uninsured patients not picked up by the Medicaid option, FFCRA and subsequent legislation established a $2…

Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 1: Insurers

…“no wrong door” approach that is currently in place, which helps ensure that consumers enroll in the coverage program for which they are eligible, whether it be Marketplace, Medicaid, or CHIP. Additionally, a main purpose of the Marketplace is to provide a single, one-stop-shop for all available qualified health plans (QHPs). When the options for enrollment are scattered across different…

Navigator Guide FAQs of the Week: Who Qualifies for a Special Enrollment Period?

…enrollment opportunity. Some events that trigger a special enrollment opportunity are: Loss of minimum essential coverage or other qualifying coverage. For example, if you lose your employer-sponsored coverage because you quit your job, were laid off, or if your hours were reduced. This also includes “aging off” a parent’s plan when you turn 26 or if you lose student health…

Navigator Guide FAQs of the Week: Covid-19 Pandemic Concerns

…hours at work were cut back due to the COVID-19 pandemic, resulting in a temporary loss of income. Can I qualify for premium tax credits? Possibly. If you are already enrolled in a marketplace plan (either through HealthCare.gov or your state’s marketplace), you should report the change in income. If you previously qualified for premium tax credits, and your income…

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.